Saturday, September 17, 2011
thoughts on words-beyond the written
the importance of connections can not be underestimated in the world of health care literacy.for those who are in the "non-print" world we as professionals must find ways to include and engage our patients with compassion and a non-judgemental attitude. we need to make the "invisible" "visible" and connect the meanings of the words to a meaning for the audience. the old adage "if at first you don't succeed" has life changing and life-sustaining importance to patients.
knowing our audience takes on special meaning when nurses provide important information to patients. we need to know the limitations, strengths, and support systems that individuals have. how we approach a teenager and a non-custodial or custodial parent, an elderly patient with symptoms of dementia and an adult care giver, parents of a non-verbal infant when the parents only speak German or Chinese, or an educated engineer familiar with jet-propulsion " there are no one-way guarantees that what we say is what is heard. perhaps that is why some of the new medical initiatives that connect patients across the health care continuum are so important. did the patient remember their reading glasses? did the parent show up 1/2 way into the appointment with the teen ager? is the dementia gaining control of the activities of daily living that frustrate patient and care-giver? these are all issues that influence how the important information nurses try to give the patient. BUT ultimately what is the information the patient and family need to connect with their everyday world of living? What can we change as health care providers and when do we adjust our expectations to fit the patient and family expectations?
knowing our audience takes on special meaning when nurses provide important information to patients. we need to know the limitations, strengths, and support systems that individuals have. how we approach a teenager and a non-custodial or custodial parent, an elderly patient with symptoms of dementia and an adult care giver, parents of a non-verbal infant when the parents only speak German or Chinese, or an educated engineer familiar with jet-propulsion " there are no one-way guarantees that what we say is what is heard. perhaps that is why some of the new medical initiatives that connect patients across the health care continuum are so important. did the patient remember their reading glasses? did the parent show up 1/2 way into the appointment with the teen ager? is the dementia gaining control of the activities of daily living that frustrate patient and care-giver? these are all issues that influence how the important information nurses try to give the patient. BUT ultimately what is the information the patient and family need to connect with their everyday world of living? What can we change as health care providers and when do we adjust our expectations to fit the patient and family expectations?
Sunday, September 11, 2011
Images for Nurses
i encourage all nurses to search out images for the following:
Call it a Humanities Scavenger Hunt
Florence Nightingale Lady with the Lamp
The Scream
The Ghost Hunters television show-any episode of a haunted "TB" or "Insane" Hospital
Law and Order episodes that show how health care literacy goes beyond the patient into the world we all live in.
Over just one evening of television watching record how many medically oriented commercials you are exposed to including medication, medical treatments, and even foods
Watch the two movies to compare
The Fisher King and The Beautiful Mind
Read the Yellow Pages and the local newpaper's Health section
Read the newspaper or watch the news to see what medical conditions or excuses influence our everyday ?world. Are human images included and how do those images affect us? Do we share compassion or revulsion?
Is there a special health care literacy that would enhance or prevent issues that impact ourselves, our neighbors, etc?
As always these are just my personal thoughts about how we all connect. Such observations will show that health care literacy DOES NOT exist in a vacuum.
How do we as healthcare providers evaluate the truth and relevance of what we read and see? What is our responsibilities to our patients? What is our responsibility to our profession?
I believe educating patients can not be without keeping ourselves as nurses educated to medical changes, best practice guidelines, and always being educated in the expectations, needs, and capabilities of our patients in their current
Call it a Humanities Scavenger Hunt
Florence Nightingale Lady with the Lamp
The Scream
The Ghost Hunters television show-any episode of a haunted "TB" or "Insane" Hospital
Law and Order episodes that show how health care literacy goes beyond the patient into the world we all live in.
Over just one evening of television watching record how many medically oriented commercials you are exposed to including medication, medical treatments, and even foods
Watch the two movies to compare
The Fisher King and The Beautiful Mind
Read the Yellow Pages and the local newpaper's Health section
Read the newspaper or watch the news to see what medical conditions or excuses influence our everyday ?world. Are human images included and how do those images affect us? Do we share compassion or revulsion?
Is there a special health care literacy that would enhance or prevent issues that impact ourselves, our neighbors, etc?
As always these are just my personal thoughts about how we all connect. Such observations will show that health care literacy DOES NOT exist in a vacuum.
How do we as healthcare providers evaluate the truth and relevance of what we read and see? What is our responsibilities to our patients? What is our responsibility to our profession?
I believe educating patients can not be without keeping ourselves as nurses educated to medical changes, best practice guidelines, and always being educated in the expectations, needs, and capabilities of our patients in their current
continuing with reading etc
The wheel of Life A memoir of Living and Dying, Dr. Elisabeth Kubler-Ross' autobiography combines the personal, the public, the political of her search for helping patients and medical personnel find common ground in what they need to know, what they want to know, what we as health care providers feel they MUST know and follow. The issues of our medical judgement surrounding "non-complience" makes health care literacy relevant to individuals. How do we as nurses "listen" to the verbal and non-verbal messages from patients? How do we as professionals combine compassion, caring, and respect of the patient in our expectations for the patient? In the end it is always about the patient and the patient's choice.
Perhaps in this world of quick MD visits and hospitals where the nurses are "never the same" we have to examine where trust and follow up takes place for patients.
As I examine more antodotal information and multi discipline research-I see time and purpose coming to the forefront. Equally important seems to be the comfort level of those of us who teach-both with diverse patient, the innformation we need to teach, and the goals.
Perhaps in this world of quick MD visits and hospitals where the nurses are "never the same" we have to examine where trust and follow up takes place for patients.
As I examine more antodotal information and multi discipline research-I see time and purpose coming to the forefront. Equally important seems to be the comfort level of those of us who teach-both with diverse patient, the innformation we need to teach, and the goals.
for me-reading and reading and oral stories
i have been fortunate in my life to always be around books and people who like books likewise it has been a blessing to be around storytellers. stories help place people in a time and place with a purpose. to all of my colleagues who question the relevance of the humanities in nursing-i suggest that the stories found in books, movies, paintings, photographs, theatre, and academic writings offer connections to our world. Those connections are important for literacy and therefore health care literacy because of how doctors, nurses, patients, family members, and others share their worlds. It is about knowing and most importantly remembering how we get to the life we are now living.
i would like to share a couple of books that may be worth reading-
Other People's Words, The Cycle of Low literacy by Victoria Percell-Gates. This book offers a poignant example of how health care can exclude rather than include the needs of patients by not recognnizing where they are and why. the reading offers a starting place for remembering why patients are where they are and not to be judgemental as we search for ways to connect
i would like to share a couple of books that may be worth reading-
Other People's Words, The Cycle of Low literacy by Victoria Percell-Gates. This book offers a poignant example of how health care can exclude rather than include the needs of patients by not recognnizing where they are and why. the reading offers a starting place for remembering why patients are where they are and not to be judgemental as we search for ways to connect
Sunday, September 4, 2011
placing ourselves in our patients' world
I have had a number of colleagues again ask "why do I need to know humanities? i am a nurse?
My response continues to be "we need to communicate with patients and families. Often they do not know medical jargon or they do not know how to fit medical information in their lives. Having knowledge of the humanities through art, history, sociology, history, psychology gives nurses, patients, and families points of reference for clear language they may (and I want to make sure we understand the concept "may")stress the importance of applying medical information to living lives.
We all need to understand the place we all find ourselves in the world of health care literacy.
Dean Schillinger, MD (of the teach back method) in his commisioned paper "Improving Chronic disease Care for Populations with Limited Health Literacy" in the Institute of the National Academis' paper A Prescription to End Confusion- prologues his wor with a quote from George Bernard Shaw "the problem with communication is the assumption that it has occurred".Within the same work Barry D. Weiss, MD's paper (also commissioned) "Outside the Clinician-Patient Relationship-A Call to Action for Healthe Literacy" addresses the interconnection in all aspects of a patient's life that are impacted by health care information. Health does nnot exist in isolation it exists in living.
Ultimately the choice is the patient's-everyone else can only provide reliable information and realistic expectations.
I am astonished that with the money spent on "clear language" much of the drug information is complicated and in very small print. It appears that we have much work to still do on how the text is presented and what the text presents at first glance. What the patient sees, remembers, and uses to facilitate THEIR healthcare remains the ultimate test of information medical personel share and explain.
My response continues to be "we need to communicate with patients and families. Often they do not know medical jargon or they do not know how to fit medical information in their lives. Having knowledge of the humanities through art, history, sociology, history, psychology gives nurses, patients, and families points of reference for clear language they may (and I want to make sure we understand the concept "may")stress the importance of applying medical information to living lives.
We all need to understand the place we all find ourselves in the world of health care literacy.
Dean Schillinger, MD (of the teach back method) in his commisioned paper "Improving Chronic disease Care for Populations with Limited Health Literacy" in the Institute of the National Academis' paper A Prescription to End Confusion- prologues his wor with a quote from George Bernard Shaw "the problem with communication is the assumption that it has occurred".Within the same work Barry D. Weiss, MD's paper (also commissioned) "Outside the Clinician-Patient Relationship-A Call to Action for Healthe Literacy" addresses the interconnection in all aspects of a patient's life that are impacted by health care information. Health does nnot exist in isolation it exists in living.
Ultimately the choice is the patient's-everyone else can only provide reliable information and realistic expectations.
I am astonished that with the money spent on "clear language" much of the drug information is complicated and in very small print. It appears that we have much work to still do on how the text is presented and what the text presents at first glance. What the patient sees, remembers, and uses to facilitate THEIR healthcare remains the ultimate test of information medical personel share and explain.
Tuesday, August 16, 2011
health care literacy-advocacy and finding common grounds
I am reminded of the responsibility of nurses to advocate for the patient,their families and their profession through health care literacy. Through conversations with colleagues, patients, and families we need to sort out what is needed to be known, where care can be obtained, how to do what is needed to be done to promote the highest level of health for the individual. Nurses often meet patients and families by chance and by necessity. The relationship's fluidity depends on needs very much in the present with hopefully a look to the future.
This entry may be a trifle like being on a soapbox-but I have a reason.
Holding each other accountable has been a lot on my mind. Maybe it is because I have been a nurse for over 35 years. Maybe it because for me it is always about the patient and my peers. Or maybe it is because of my believe that "there is no I in teamwork"
whatever the case, health care literacy creeps up without a limited place or prime time time slot due to the fluidity of circumstances and needs. Health needs do not stop at 4:30 or on a week end or on a holiday. Knowing how to access information and having the access is part of the doctor/nurse/patient/family partnership needed for health care literacy that make a difference in the lives of people.
NURSES are UNIQUE and are among the front line when patients and their families want information.
On a local level-we have a responsibility to care for our colleagues who care for our clients.
I am reminded that all of us have different ways of "doing things". Yet I am a believer that "someone has to do it..." We are all in this place together-this place call nursing.
On a public and political level-we have a responsibility to advocate by being involved and knowledgeable.
We need to maintain our competencies while staying informed.
To help patients navigate the growing information blitz, we need to know what they are seeing, hearing, and learning.
THOUGHTS TO PONDER
What do we,as nurses, see when we see the following?
At the end of the day,I believe it is about connections, responsibilities, and accountability.
That is what I see, what do you see?
And again, I need to say everyone has different ways of "doing nursing".
UNITE for a healthy future
Sunday
September 12
12:00 pm - 6:00 pm
CENTRAL PARK,NYC
LET'S CYCLE, THROW, JUMP, AND HOOP TO FIGHT
CANCER, DIABETES, HEART AND LONG DISEASE
Maybe we see ourselves, friends, family members, clients affected by these non-communicable diseases being addressed at the United Nations Summit.
I have two uncles who have cardiac issues secondary to diabetes (one had adequate care and one had no access to the things he needed to live and did not know who to ask). At work, we presently have 14 patients on a telehealth buddy system that transmits weights and vital signs for complications of Congestive Heart Failure. One of my colleagues I highly respect, has had to deal with bureaucracy of the medical field in assuring that her dying patient does not die with pain that can be relieved. She is the voice to help the family navigate the road to painlessness. Sometimes there is only health care ILLITERACY. I am proud to call her a friend as she sees what needs to be done, does it, all the while respecting the patient and the family. She explained the addictive myth that surrounds the use of medications for comfort.
Maybe we see a specific cause that we can advocate for to bring better health to people?
A personal favorite advocacy group is tudiabetes.org. This group through Mannie's leadership has brought faces to diabetes (and hands check out the site this was developed into a hospital unit in service and service project a number of years ago).
Through their site I was brought to the United Nations Summit and a connection to diabetes as a Global Epidemic.
Nurses are offered a way to join a personal political voice through the International diabetes Federation and their "O is for Outrage" campaign.
Nurses can give a voice to patients who have none or just are a whisper.
"O is for Outrage" is a call for President Obama to represent us-nurses, patients, and families at the UN Summit" by speaking to the Global epidemic of Diabetes
"we do not want the world to sleepwalk into a sick future that is avoidable" Ann Keeling, IDF, CEO
My plan is always to share.
I wrote my postcard and sent the site to some of my friends.
I hope to have my colleagues who can not go to NYC Jump rope and hoop when they come to the office to show our support.
Our hospital library has an audio CEU on congestive heart failure that gives us a CEU.
My children(now grown just send me paper money) and I have always collected pennies all year and decided on a cause-this year UNICEF won again. Food, water, and safety for children tear at my heart.
Yes, we have problems here in the US and for those who may criticize my belief in global professional advocacy-I do my local work also.
Health Care literacy is about knowing how to share what needs to be done, how to do it, and how to access what is needed to do what needs to be done.
This entry may be a trifle like being on a soapbox-but I have a reason.
Holding each other accountable has been a lot on my mind. Maybe it is because I have been a nurse for over 35 years. Maybe it because for me it is always about the patient and my peers. Or maybe it is because of my believe that "there is no I in teamwork"
whatever the case, health care literacy creeps up without a limited place or prime time time slot due to the fluidity of circumstances and needs. Health needs do not stop at 4:30 or on a week end or on a holiday. Knowing how to access information and having the access is part of the doctor/nurse/patient/family partnership needed for health care literacy that make a difference in the lives of people.
NURSES are UNIQUE and are among the front line when patients and their families want information.
On a local level-we have a responsibility to care for our colleagues who care for our clients.
I am reminded that all of us have different ways of "doing things". Yet I am a believer that "someone has to do it..." We are all in this place together-this place call nursing.
On a public and political level-we have a responsibility to advocate by being involved and knowledgeable.
We need to maintain our competencies while staying informed.
To help patients navigate the growing information blitz, we need to know what they are seeing, hearing, and learning.
THOUGHTS TO PONDER
What do we,as nurses, see when we see the following?
At the end of the day,I believe it is about connections, responsibilities, and accountability.
That is what I see, what do you see?
And again, I need to say everyone has different ways of "doing nursing".
UNITE for a healthy future
Sunday
September 12
12:00 pm - 6:00 pm
CENTRAL PARK,NYC
LET'S CYCLE, THROW, JUMP, AND HOOP TO FIGHT
CANCER, DIABETES, HEART AND LONG DISEASE
Maybe we see ourselves, friends, family members, clients affected by these non-communicable diseases being addressed at the United Nations Summit.
I have two uncles who have cardiac issues secondary to diabetes (one had adequate care and one had no access to the things he needed to live and did not know who to ask). At work, we presently have 14 patients on a telehealth buddy system that transmits weights and vital signs for complications of Congestive Heart Failure. One of my colleagues I highly respect, has had to deal with bureaucracy of the medical field in assuring that her dying patient does not die with pain that can be relieved. She is the voice to help the family navigate the road to painlessness. Sometimes there is only health care ILLITERACY. I am proud to call her a friend as she sees what needs to be done, does it, all the while respecting the patient and the family. She explained the addictive myth that surrounds the use of medications for comfort.
Maybe we see a specific cause that we can advocate for to bring better health to people?
A personal favorite advocacy group is tudiabetes.org. This group through Mannie's leadership has brought faces to diabetes (and hands check out the site this was developed into a hospital unit in service and service project a number of years ago).
Through their site I was brought to the United Nations Summit and a connection to diabetes as a Global Epidemic.
Nurses are offered a way to join a personal political voice through the International diabetes Federation and their "O is for Outrage" campaign.
Nurses can give a voice to patients who have none or just are a whisper.
"O is for Outrage" is a call for President Obama to represent us-nurses, patients, and families at the UN Summit" by speaking to the Global epidemic of Diabetes
"we do not want the world to sleepwalk into a sick future that is avoidable" Ann Keeling, IDF, CEO
My plan is always to share.
I wrote my postcard and sent the site to some of my friends.
I hope to have my colleagues who can not go to NYC Jump rope and hoop when they come to the office to show our support.
Our hospital library has an audio CEU on congestive heart failure that gives us a CEU.
My children(now grown just send me paper money) and I have always collected pennies all year and decided on a cause-this year UNICEF won again. Food, water, and safety for children tear at my heart.
Yes, we have problems here in the US and for those who may criticize my belief in global professional advocacy-I do my local work also.
Health Care literacy is about knowing how to share what needs to be done, how to do it, and how to access what is needed to do what needs to be done.
Thursday, August 11, 2011
clear communication-the private and personal as wll as the public and political
with all the changes to health care communication appears to be the key...
communication for the patient and family to access care, information, and navigate around all the places they can find information is of critical importance to promote and maintain health
advocating for yourself and for those who have no voice is imperative is this time of insurance quagmires, family physicians vs hospitalists,nurses and other health care professionals
topics to be pondered may include
TIME
Money
Personal Responsibility
Professional Responsibility
Accountability
Doing the right thing the right way
What we know is not always what we do
What we think we know is not always what we should do
At the end of the day we have the personal responsibility to take action
SEPT 18th
Central Park, NYC
Unite for a Healthy Future
Let's Cycle, Throw, Jump, and hoop to fight
Cancer, Diabetes, Heart and Long Disease
As nurses I hope to engage my peers
we might not be able to go to the Big Apple
....but we can join together
at work
and send our support to the
United Nations Summit on Global Health Issues
Prevention and control of non-communicative Diseases
1. By coming to the office to hula hoop or jump rope for 1 minute Sept 18th
Sign the letter for the UN in support
2. By August 29th
Go to the International Diabetes Federation Website and Prepare an " O is for
Outrage" postcard to be sent to President Obama asking him to support quality
care and access to health care for all
ADVOCATING SEEMS TO BE ABOUT ACCESSIBILITY, RESPONSIBILITY, AND ACCOUNTABILITY ON MANY LEVELS
........hummm
these are issues i think i need to explore
communication for the patient and family to access care, information, and navigate around all the places they can find information is of critical importance to promote and maintain health
advocating for yourself and for those who have no voice is imperative is this time of insurance quagmires, family physicians vs hospitalists,nurses and other health care professionals
topics to be pondered may include
TIME
Money
Personal Responsibility
Professional Responsibility
Accountability
Doing the right thing the right way
What we know is not always what we do
What we think we know is not always what we should do
At the end of the day we have the personal responsibility to take action
SEPT 18th
Central Park, NYC
Unite for a Healthy Future
Let's Cycle, Throw, Jump, and hoop to fight
Cancer, Diabetes, Heart and Long Disease
As nurses I hope to engage my peers
we might not be able to go to the Big Apple
....but we can join together
at work
and send our support to the
United Nations Summit on Global Health Issues
Prevention and control of non-communicative Diseases
1. By coming to the office to hula hoop or jump rope for 1 minute Sept 18th
Sign the letter for the UN in support
2. By August 29th
Go to the International Diabetes Federation Website and Prepare an " O is for
Outrage" postcard to be sent to President Obama asking him to support quality
care and access to health care for all
ADVOCATING SEEMS TO BE ABOUT ACCESSIBILITY, RESPONSIBILITY, AND ACCOUNTABILITY ON MANY LEVELS
........hummm
these are issues i think i need to explore
Saturday, July 9, 2011
Back , Ready, and Needing to Continue
Another new nursing position and new learning curve has postponed my writings-but my thought, research, and work with Health Care Literacy has continued. Thanks to all my colleagues for their encouragement. My goal by the end of the year is to have my thesis written, reviewed, and accepted allowing me to graduate May 2012. My long term goal is to have nurses who are responsible for educating patients and families UNDER THE DIRECTION OF THE PHYSICIAN, through collaboration with all disciplines and department, using information grounded in theory and best practices accepted as non-traditional educators.
I have not been negligent in my accumulation of "stuff" regarding Health Care Literacy. i have only been bad about updating this blog. As always I have continued to place nurses in the loop as educators for patients and their families.
I had 2 interesting experiences with academia that had me struggling with my goals and purpose as a nurse.
One was positive-the gracious acceptance of my paper By OSU at their Expanding Literacy Studies International conference for Graduate Students spring 2009. Not only did I present but had the dubious experience of being a Panel chair. Thank you to Harvey Graff for smashing the literacy myth beyond the classroom and into real work applications.
the other was actually disappointing. My own Penn State University had a Conference on Non-traditional Adult Learners (I had developed a Power Point grounded in theory and best nursing practices for Nurses that was politely rejected because not "classroom oriented")
Now with changes in the Health Care Community I believe my beliefs have been validated and as a nurse for a nurse and most importantly for the patient and families I am rejuvenated.
So more will come....and I hope it will be useful as nurses continue to provide competent, compassionate, and appropriate care to patients trying to enter into
the important health conversations that affect their lives.
I have not been negligent in my accumulation of "stuff" regarding Health Care Literacy. i have only been bad about updating this blog. As always I have continued to place nurses in the loop as educators for patients and their families.
I had 2 interesting experiences with academia that had me struggling with my goals and purpose as a nurse.
One was positive-the gracious acceptance of my paper By OSU at their Expanding Literacy Studies International conference for Graduate Students spring 2009. Not only did I present but had the dubious experience of being a Panel chair. Thank you to Harvey Graff for smashing the literacy myth beyond the classroom and into real work applications.
the other was actually disappointing. My own Penn State University had a Conference on Non-traditional Adult Learners (I had developed a Power Point grounded in theory and best nursing practices for Nurses that was politely rejected because not "classroom oriented")
Now with changes in the Health Care Community I believe my beliefs have been validated and as a nurse for a nurse and most importantly for the patient and families I am rejuvenated.
So more will come....and I hope it will be useful as nurses continue to provide competent, compassionate, and appropriate care to patients trying to enter into
the important health conversations that affect their lives.
Subscribe to:
Comments (Atom)
